NPI | 1992781462 |
---|---|
Former Name | JULIE MARIE BOLENBAUGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AL MD 29839) |
Additional Taxonomies | 208D00000X General Practice (Licence: SC 26530) |
Enumeration Date | 2005-12-16 |
Last Update Date | 2013-06-18 |